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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610183
Report Date: 10/07/2022
Date Signed: 10/07/2022 02:02:45 PM


Document Has Been Signed on 10/07/2022 02:02 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364



FACILITY NAME:OAKMONT OF VALENCIAFACILITY NUMBER:
197610183
ADMINISTRATOR:CYNTIA DRACHENBERGFACILITY TYPE:
740
ADDRESS:24070 COPPER HILL DRIVETELEPHONE:
(661) 568-6080
CITY:VALENCIASTATE: CAZIP CODE:
91354
CAPACITY:144CENSUS: 106DATE:
10/07/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Cyntia Drachenberg, Executive DirectorTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Angela Panushkina conducted unannounced visit to this facility. LPA met with the Executive Director and explained that this visit was conducted to address the incorrect deficiency report that was issued on 09/28/22 (Complaint Control # 31-AS-20220805133307) due to a technical/computer glitch issue.

On 09/28/22, LPA issued a civil penalty of $23,100.00 due to a repeated deficiency violation in error (LIC809 and LIC809-D)

During today's visit LPA issued a new Case Management Deficiency report to this facility with a correct civil penalty in the amount of $1000.00

Exit interview conducted. Appeal rights explained. Copy of this report signed and delivered.

SUPERVISOR'S NAME: Nichelle GillyardTELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Angela PanushkinaTELEPHONE: 747-230-3364
LICENSING EVALUATOR SIGNATURE:
DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/07/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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